What Neurological Disease Does Alcohol Cause?

As Annie Grace writes in This Naked Mind, at a certain point (maybe even from the very beginning), alcohol takes more than it gives: “Alcohol erases a bit of you every time you drink it. It can even erase entire nights when you are on a binge. Alcohol does not relieve stress; it erases your senses and your ability to think. Alcohol ultimately erases your self.”

The negative effects can be especially noticeable when it comes to our nervous system. Alcohol makes us lose our balance, slur our words, say things we don’t mean, and forget things we want to remember. We might lose entire chunks of nights or days and could end up with permanent damage to our brain and central nervous system if we’re not careful. What are the long-term effects of alcohol on the nervous system? And what are the signs of neurological damage from alcohol? Let’s explore!

The Brain and Body on Booze: Immediate Effects

How does alcohol affect the nervous system in the short term? Let’s take a brief look:

• Dopamine. As soon as we start drinking, alcohol floods our brain with dopamine — the feel-good neurotransmitter that evolved to keep us coming back to things that help us survive by giving us a biochemical “reward” for socializing or eating nutritious food. The problem? Alcohol and other substances can hijack this system, keeping us coming back to things that are, well, not at all conducive to survival.
• Memory and impulse control problems. Ever notice how it’s that much harder to remember the names of people you meet while drinking (or how inappropriate things have a way of slipping out more easily)? Alcohol muddles the connections in our prefrontal cortex (responsible for executive functions) and messes with the hippocampus, which is in charge of creating new memories. The brain fog that results can persist well into the next day.
• Headaches. In some folks, congeners in certain types of alcohol are responsible for headaches and we all get them sometimes. Known as “cocktail headaches,” they’re caused by dehydration and vasodilation (the widening of blood vessels).
• Mood swings. By messing with our amygdala (which processes emotions), alcohol tends to cause mood instability. That “everyone is our friend” feeling can quickly turn into a crying spell or an angry outburst.
• Anxiety and depression. Although we often drink to relieve anxiety and feel “better,” the result tends to be the opposite — especially the next morning. Remember, what goes up must come down, and our brain chemistry is no different. That rush of dopamine we experienced the night before quickly fades away, giving rise to next-day “hangxiety.”

Want more information? Check out “Alcohol Consumption and Changes in the Brain.” But for now, let’s turn our attention to another question: Does alcohol affect the nervous system in the long term? As you can probably guess, the answer is yes.

As Time Goes By: Long-Term Effects of Alcohol on the Nervous System

Given the powerful effects alcohol has on our nervous system from the first sips, it’s only natural that it can wreak havoc in the long term. But what are the long-term effects of alcohol on the nervous system? And what are the signs of neurological damage from alcohol? Let’s take a closer look.

1. Alcoholic Neuropathy

Alcoholic neuropathy is a common condition among long-term heavy drinkers. It results from nerve damage caused by alcohol’s toxic effects, as well as from malnutrition that happens with alcohol getting in the way of nutrient absorption in the gut. Here are the typical symptoms:

• Our legs feel off. If we’re noticing frequent pain, tingling, or numbness in our legs, drinking might be the cause. (It’s kind of similar to alcohol-related leg pain and restless leg syndrome, only taken up a notch).
• Our muscles feel weak. We might notice that climbing stairs, lifting wet laundry out of the washer, carrying groceries, and other everyday tasks get harder. The reason has to do with the disruption of nerve signals that keep our musculoskeletal system running smoothly.
• We might experience erectile dysfunction. Unfortunately, this embarrassing problem (which alcohol is often responsible for) gets worse as booze wreaks havoc on our nervous system, disrupting those ever-so-important chemical messages.
• We’re having digestive problems. Similar to other bodily functions, digestion is regulated by nerves. And when there’s trouble with transmission, there’s going to be trouble in the gut, leading to stomach pain, bloating, diarrhea, or constipation. Ugh. 
• Urination gets tricky. Another bathroom-related mishap associated with alcohol-related neuropathy — urination difficulties. Expelling fluids out of our system involves a delicate system regulated by nerve impulses. With alcohol in the picture, signals get lost in transmission and communication goes awry.

While alcohol-related neuropathy might be treatable at early stages, it can get serious very quickly. Still, if we stay away from booze and replenish lost vitamins — especially vitamin B — we should start feeling better within a few weeks.

2. Central Pontine Myelinolysis (CPM)

We all know that booze dehydrates us. Yes, it’s a liquid — but it’s one that sends us to the bathroom throughout the night, leaving us parched and depleted of fluids and electrolytes (such as sodium) by morning. The reason behind this pesky (and potentially dangerous) effect is vasopressin, the hormone that tells the kidneys to hold on to water. Alcohol suppresses it, draining us of more liquids than we can afford to lose as a result.

If things get really bad, dehydration can cause hyponatremia (a fancy name for low sodium levels). Rapid correction of alcohol-induced hyponatremia, in turn, can damage the part of the brain that controls balance and motor function. The result? Central pontine myelinolysis, a condition also associated with severe burns, liver transplantation, anorexia, and severe morning sickness during pregnancy, and hyperglycemic states. 

We might have difficulty speaking, problems swallowing, and coordination issues. The condition is serious, potentially leading to paralysis. While prevention is certainly the “best cure” in this case, medications such as desmopressin have proven to be helpful, and the state can be reversed if we seek medical help in time.

3. Hepatic Encephalopathy

Another well-known fact about alcohol? It does a number on our liver, which is at the front lines of alcohol metabolism. Every drink we throw back gets processed by the liver — about one per hour — and over time it gets overtaxed. Liver inflammation from excessive drinking leads to fatty liver and, eventually, cirrhosis — the scarring of tissues that can lead to liver failure if not addressed right away. 

But as it turns out, the liver isn’t the only victim here — our brain is as well. When the liver is overworked, it can’t process other toxins — including substances such as ammonia — in time. The result? They make their way to the brain, leading to hepatic encephalopathy. Here are the typical symptoms:

• Confusion. We might feel confused as our brain function gets disrupted.
• Changes in personality. Others might notice that we don’t seem “like ourselves” — our easygoing nature might give way to irritability, our sense of humor might change, and we might become more impulsive.
• Judgment problems. As our brain is exposed to the toxic effects for longer periods of time, it has even more trouble functioning. Decisions become difficult, we might make impulsive judgments, or take unnecessary risks. 

While symptoms might be subtle at first, it’s crucial to take note, as they can progress to coma and death if untreated.

4. Alcohol-Related Brain Damage (And Wernicke-Korsakoff Syndrome)

One of the most serious forms of neurological disease that alcohol can cause is alcohol-related brain damage (ARBD), a term that covers a range of conditions and includes the notorious Wernicke-Korsakoff syndrome. 

ARBD refers to a spectrum of brain disorders caused by excessive drinking and the nutritional deficiencies that leave the brain depleted of much-needed vitamins. They generally show up as problems with memory, learning, and other cognitive difficulties. As the problem gets worse, we might experience balance trouble or impaired motor skills.

Wernicke-Korsakoff syndrome — caused mainly by deficiencies in vitamin B1 (thiamine) — is one of the most serious types of damage alcohol can cause.

• The first stage is Wernicke’s encephalopathy. The first stage of WKS causes confusion, loss of muscle coordination, and problems with vision. We might experience eye movement abnormalities or get double vision. 
• If untreated, it can progress to Korsakoff psychosis. This is where things get really rough — potentially irreversibly so. Korsakoff’s psychosis is marked by severe learning and memory problems. We might have large gaps in our memory and be driven to “confabulation” — filling them in with made-up events. (For more information, take a look at “What Is Wet Brain Syndrome?”)

While ARBD (and especially WKS) is serious, there’s hope! If we stop drinking in time and replenish our B vitamins, recovery is often possible, at least to some degree.

5. Depression and Anxiety

Last but not least, alcohol misuse can cause depression and anxiety. While both can result from a night of heavy drinking, if we keep our intake high, neurological changes could set in, darkening our view of the world or ramping up our anxiety on a more long-term basis. 

The reason has to do with those neurotransmitter shifts we touched on earlier. Alcohol artificially floods our brain with dopamine, leading to that brief boost of feel-good energy we end up chasing (but not quite reaching, no matter how hard we try). In addition to dopamine, alcohol boosts GABA — an inhibitory neurotransmitter — while lowering glutamate, its excitatory counterpart. 

In an effort to rebalance itself, the brain puts the brakes on natural production of dopamine and alters the natural levels of GABA and glutamate to accommodate the “new normal.” Over time, these shifts can be difficult to reverse, leading depression and anxiety to set in. Booze doesn’t quite do it anymore and, when we stop, withdrawal sets in, ramping up both the unease and the waves of sadness.

But don’t despair! With time, the brain can rebalance itself. The key is giving it the care it deserves while changing our relationship with alcohol. Let’s take a closer look at how we can do that.

Protect Your Brain

Preventing these neurological diseases involves addressing alcohol consumption directly.

• Watch your intake. First and foremost, assess your current drinking habits. Don’t judge: simply start tracking your intake and make a plan to cut back or quit. Don’t regret the past — instead, get excited about the positive changes you’ll start seeing soon. Muscles feeling stronger? Great! You’re able to focus better on tasks such as reading and are remembering things better? Time to celebrate (with a fun mocktail)!
• Nourish your body. Make sure to nourish your brain and body with whole-grain carbohydrates, lean protein, and healthy fats (such as omega-3s found in salmon, olive oil, and avocados). The nervous system needs vitamins — especially vitamin B — to function well, so load up on fish, beans, and peas (for thiamine); chicken, turkey, beef, fish, mushrooms, peanuts, and legumes (for niacin); and leafy green vegetables, chickpeas, and fortified grains (for folate). These three types of B vitamins are essential for brain health, nerve health, and creation of neurotransmitters.
• Talk to your doctor. If you’re seeing signs of neurological damage from alcohol, don’t hesitate to ask your doctor for advice. They know you and your medical history and will be

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